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More Q&A

QUESTION: Does the Gates Foundation fund projects in the United States?

BILL GATES: Yes, we are very involved in projects in the United States. When we started the foundation, we wanted to tackle the world’s biggest inequities, wherever they are. Globally, we see the biggest inequities in the suffering of the world’s poorest people, starting with the one billion who live on less than $1 a day. We think our resources can help make a huge difference in their lives.

About 25 percent of our foundation’s resources are spent in the U.S., mostly to improve our education system, where we see some of the biggest inequities in this country. Only about one-third of U.S. students graduate from high school with the skills they need for college, even though education beyond high school is important for success in today’s economy. So we’re trying to help make teaching more effective, raise education standards, ensure that more students graduate from high school and ensure that more college students complete their degrees.

How do you select and prioritize development projects?

In the foundation’s work outside the United States, we’re focused first of all on the toughest challenges facing the world’s poorest billion people. Like not having enough food or having your children die before the age of five. Or even if your children live, having them suffer debilitating diseases. We mostly pick things that we think will have significant impact on the living conditions of the poorest.

Then, we set measurable goals and look for projects that have the best chance of helping achieve those metrics. In agriculture, for example, we have a goal to help triple farm productivity in Africa. This would be a huge increase and would make a big difference. When we decide what agriculture projects to prioritize, we look at the crop that a project is trying to enhance, what percentage of farm productivity it represents, whether it’s feasible to triple the productivity, and what impact that would have.

But some things are more subjective, like the efforts we’re supporting to enable more people to have decent flush toilets. We haven’t done a grand experiment, we haven’t given some people super nice flush toilets and let other people keep their current crummy toilets and then measured how big a difference that makes in their lives, just how crummy your life is if you have a primitive toilet and your house smells and nobody wants to marry your daughters, or whatever. We just sort of decided, based on some pretty fundamental human values, that people should have a good toilet, and shouldn’t have to wait for the expensive infrastructure that may never come to the poorest parts of cities in the developing world. So we support innovative work to kind of reinvent the toilet.

How do you measure the success of the foundation’s development projects?

It depends on our role and what we’re working on. When it comes to upstream medical invention, like inventing new malaria drugs and vaccines, we are often the largest funder. The U.S. National Institutes of Health is the only other really large funder. Measuring success is fairly simple. Do we have a malaria vaccine? Do we have a TB vaccine?

When it comes to delivery of health services, like vaccinating people or getting AIDS drugs to them, we’re part of a larger group that includes the Global Fund, GAVI, and governments. We measure success in terms of whether the percentage of people who receive services goes up and whether the prices of drugs and vaccines go down.

One of our ultimate objectives is to reduce the mortality rate for children under five years old. We want to cut it in half over the next 15 years. Meanwhile, we look at intermediate measures that we know are important to achieving that long-term goal. Did this country adopt the new vaccine and administer it effectively, or is it sitting and spoiling somewhere along the delivery pipeline?

How do you talk to or teach your children about the issues you are passionate about?

One way is just from their traveling with us. When we take them to Africa, they see what an urban slum looks like, they see what a rural thatched hut looks like. They realize that Americans’ housing must be expensive. They’re curious, so they wonder why it’s expensive, could that ever change, and how bad is it to live in a slum or a thatched hut?

Like anyone else, when they first see how the world’s poorest people live, they’re a little bit shocked. Wow, okay, this is very different, I guess I’ve taken some things for granted, like running water, a flush toilet, grass in the yard instead of mud, enough food every day.

It helps for them to meet people. If they go to an orphanage and talk to some of the kids there, maybe they see that this kid is really happy because he just got a crutch to help him walk. They think, “Oh, geez, I’ve never had to worry about something like that.”

They’re different ages, but over time they’ll learn about the bigger issues, and the science involved. They’re interested in seeing things they’re studying in school. My daughter is taking a course on African history, so she asks a lot about that. My son is very interested in politics, democracy and the unrest in some countries. He’s curious about why some countries have done better than others, like why Turkey is richer than Egypt.

They have their own interests, things they’re passionate about, and we try to help them get more information about the things they’re particularly interested in.

Do you have any suggestions for books that can help us understand poverty a bit more?

I recommend Poor Economics, which I reviewed recently. It’s by two MIT economists who’ve looked closely at what works and what doesn’t work in aid projects and fighting poverty. They have a lab with many other professors who are gathering scientific evidence that can help make aid efforts more effective. They show how poor people actually live and what barriers prevent them from climbing out of poverty. Their data is quite interesting.